Anesthetizing apparatus



w. R. HENION ANESTHETIZING APPARATUS Jan. 19, 1937.

s Sheets-Sheet 1 Filed April-'15 1933 I 11v VENTOR 681444 TEE E. HEN/0N A fro/2M5 y:

Jan. 19, 1937. w. R. HENION ANESTHETIZ ING APPARATUS Filed April 13, 1935 3 Sheets-Sheet 2 j/v VENTOR gALTEEBIVEN/ON ATTORNEYS Jan. 19, 1937. w. R. HENION 2,068,177

ANESTHETIZING APPARATUS Filed ApriI 15, 1953 5 Shet s-Sheet 5 IN V EN TOR. 1 1/44 TEE E! HEN/01v A TTORN S.

Patented nFan. i, 1937 FlCE Application April 13, 1933, Serial No. 665,897

24 Claims.

This invention relates to improvements in anesthetizing apparatus, and is an improvement over certain portions of an apparatus disclosed in my copending application for Anesthetizing apparatus, Serial Number 644,219, filed November 25, 1932. The present invention is, as in my .previous invention, concerned with means operableby the patient to keep the patient in a state known as analgesia, in which consciousness and motor ability is maintained, but in which nosubstantial pain is felt. The device finds valuable use for controlling dental and obstetrical analgesia. Y

An important feature of the present invention is the provision of means so controllable by the patient, that the gas can be shut off and air obtained while the timer is operative, with the arrangement such that if the patient is, for any reason, unable-to operate the control to stop gas and get air, this will be accomplished automatically by the timer at the end of the ,time period. Thus the gas delivery period may be lengthened or shortened by the patient.

In no machine known to me can the patient shut off the gas at any time, whether the timer is operative or not. In none can the gas be shut off by'the patient without waiting for the cutofi or timer to do it automatically.

Other features of this invention relate to means operable by the patient for directly controlling the air and bag valves including a latching mechanism which is operable by the timer to control the valves independently of the patient-control; the operation of one valve by the other; the synchronous operation of the main valve by means of the air and bag valve; the

use of a carbon dioxide absorbing means directly in the breathing line; the use of carbon dioxide absorbing means with means for by-passing analgesic or anesthetizing substance; the useof this absorber with valve meansfor stopping all or permitting a part or all of the exhaiations to .pass through the absorber; the arrangement whereby the anesthetizing by-pass tube by-passes an in-breathing valve of the carbon dioxide absorber; the inter-position of the carbon dioxide absorber in the breathing line; the ability to give oxygen to the patient while other gas is or ,is not flowing; the detachable interposition of said absorber in the breathing line; the use of an audible or visible signal or both for indicating to the doctor and/or patient that the supply of anesthetizing substance is cut off; the use. of

Q an-electrically controlled audible signal; the operation of the signal by a valve; the utilization of part of a valve latching means to operate the signal; the arrangement whereby a valve latching means moves with a timer stem independently of the timer stem; the arrangement whereby the latch tripping means is directly attached to the stem and moves independently of the patient-controlled device; the arrangement whereby a portion of the valve latching means is directly attached to a patient-controlled member which cooperates with the stem of the timer means; and all details of construction shown.

Objects, features, and advantages of the invention will be set forth in the description of the drawings forming a part of this application, and in said drawings Figure 1 is a side elevation showing the present device attached to the delivery tube of a machine-for mixing and delivering anesthetizing or analgesic substance; Figure 2 is an elevation partly in section showing the parts in their initial position corresponding to Figure 1;

Figure 3 is a view similar to Figure 2 showing the parts position as at the beginning of a tlm-' ing period, and when the patient is strongly gripping the control lever;

things, how the valve operates the signal means;

Figure 5 is a detail vertical transverse section on line 5-5 of Figure 3 showing the relation of the timer latch to the trip;

Figure 6 is a longitudinal sectional elevation illustrating the carbon dioxide removing means; Figure '7 is a diagram of the electrically controlled signaling means; and

Figure 8 is a diagrammatic section taken approximately online 8-8 of Figure 2 illustrating the manner of winding the timer operatingspring during assembly.

The present device may be attached to or form an integral part of any type of standard or specially constructed apparatus for delivering either oxygen or an anesthetizing gas, or a mixture of the two, and it is attachable to and usable with machines of either the continuous or the intermittent flow type. It can also be used with or without a, re-breathing bag.

Referring to Figure 1: Numeral 1 indicates the outer terminal portion of the delivery passage of a machine of the bag type. This tube I has leading downwardly therefrom a tube 2 to which a re-breathing bag (not shown) can be' attached. .A cap 3 closes the end of the tube when the bag is used at some other location on 2; the machine. The device of this invention may be attachedto the delivery pipe I by a union nut I which is rotatable upon a tubular extension III of easing H, which provides a chamber within which most of the operating mechanism is contained and through which the anesthetizing or other substances are delivered. and re-breathed. a

This extension I6 is provided with a passage l2, see Figure 3, which is continuous with the passage of the tube I, and in the passage I2 is fixed a nipple l3 against the outer end of which a valve seats to control delivery of the substances into the chamber. The casing H is provided in the top with a passage formed by tube |4 through which the gases are delivered to the patient, This tube is suitably secured to the casing II as shown. Ina vertical side wall of the casing is a passage l5 communicating with the passage of the tube l6, which latter passage delivers into the re-breathing bag. The bag may be attached either at 2 or l6. The cap fits either 2 or l6. There is also in this side wall a second passage, I! which communicates with the passage of the tube l6, these latter passages providing means for intake of air. 6

Referring to Figures 2 and 4, a plate valve 2!) slides against the inner surface of the vertical wall 2| of the casing, and this valve is pivoted on a stub shaft 22 of the casing. The valveis adapted, when there is no, delivery of anesthetizing substance to close only the bag passage l5,

.as shown in Figure 2. During flow of gas this valve closes only the air passage H, as in Figure 3. I I

The passage in the nipple I3 is closed bya suitable valve 23 carried by a lever 24 pivoted as at 25 to the wall 2|. This lever has a rightangular extension 30, which has in its lower edge a depression 3|, which is engaged by a radial extension or, cam 32 of the valve 20. To the outer end of the extension 36 is attached a spring" 33, in turn suitably attached to the easing, and which acts to hold the extension 36 against the projection 32, and also to move the lever in a direction to close the valve 23. The arrangement is such that when the parts are positioned as shown in Figure 2, the valve 23 is positioned to prevent delivery of anesthetlzing or other substance from the passage l2 into the casing or into the passage H which leads to the patient. However, when the valve 20 assumes the position shown in Figure ,3, to c'losethe air passage l1, cam 32 moves the lever 24 and opens the valve 23. The valve 23 is thus controlled in. a predetermined manner by valve 20.

In order that the plate valve 20 may be held sealingly against the wall 2|. see Figure 4, the stub shaft 22 has rotatable thereon a sleeve 31 having a plate extension 36 which is opposed to and spaced from the plate valve 20. This valve has attached thereto a pin 39 which passes through an opening in' the plate 36, and a washer and screw fastening means generally in. dicated at 40 secures the sleeve 31 against outward motion, but the sleeve is capable of inward motion. Between the plates 20, 33. is interposed casing ||,'as shown, to normally hold the valve '20 in the position shown in'Figure 2, and of course the valve is opened against the action of thisspring. 9

.for notifying the doctor or patient The pin 39 acts to operate a signalir? device hat the supply of anesthetizing or other substance is shut off, and that air is obtainable through the breathing tube. For this purpose, the outer end of' the pin is slidably engaged ina slot 45, atthe end of an arm 46, having stub shaft 41 'journaled in the cover 48 of thecasing II. To the shaft 41 is suitably attached a bell clapper having flexible portion 50. This clapper rings bell 53, see Figure I, mounted on theouter side of cover'48.. When the valve 20' moves to the,

position shown in. Figures 1 and 2, the clapper 52 rings the bell.

I contemplate the use of 'another -kind of signaling means in which an arm 54, see Figure '7, is substituted for the clapper, and operates a switch indicated at 55 to close a circuit or circuits for operating a-visual or an audible or both. Description of this feature is com-, pleted below.

the patient can control the valves to stop gasdelivery independently of the timer, and while the timer is operative. Moreover, the "patient can, as in my first application, reset the timer to increase the gas dosage at any time during the time period. Referring first to Figure 3: The casing II which is cast, is provided with an inwardly extending tubular element 60 in which is slidably operable a stem 6| of a piston 62 ,which piston operates in a cylinder 63 suitably detachably secured as' at' 64 at the outer side of the casing A spring 65 surrounds the stem 6| and issecured at one end as at 66 to the tube 60, and at the other end as at 61 to the, piston. In assembling this spring it is first attached at the point 66 and is then wound in a clockwise directiomsee diagram Figure 8. After winding its end is attached at 61, so that the spring is undertension tending to rotate the stem 6| in anti-clockwise direction, as viewed from -.the

right of Figures 2 and 3, for a purpose described below. v V

v To control the out-flow-of air from the piston, when moving to the right under the action of the compression spring 65, to obtain the proper timing period, there is provided an outlet passage passing upwardly through an extension 12. Threadingly engaged with the bore of this extension as at 13 is a needle valve 14 seating at 15. The valve has attached thereto a pointer arm 16 which rides over a suitable timer scale (not shown) on a plate 11 attached to the top'of casing the scale may be made to accurately obtain the desired time period for delivery of the analgesic substance. The passage 10 communicates, when the valve is open, with passage 18 at the-opposite side of the valve seat 15, which passage leads to the atmosphere.

A fine valve adjustment in accordance with 'The stem 6| has a'sliding fit in the end wall of the tubular extension 60, and is also supported by piston 62 and by the end which slides in the -bore 80 of a. pIunger BI translatable in anextension 82 of easing This plunger is controlled I by the riatient and has suitably attached thereto as at 84, a wire 85 (also see Figure l), which passes outwardly through a sleeve '66 rotatable I assume the position of Figure 1.

upon the tubular extension 82. This wire passes through a flexible connection 81 attached to tube 88, and through another flexible connection 89 and tube 98. To the tube 98 is attached a handle or grip element 9| to which is pivoted, as at 92, an operating lever 93, to the outer end of which lever the wire 85 is attached as at 98. The'element 9| may be the arm of a dental chair or the rail of a bed and provides something which can be utilized as a basis for whole-hand gripping by the patient. There is no intention to'be limited to this particular type of control, because in conjunction with some features herein, the type of control is unimportant, provided it is a patient control. I

The lever 93 is controlled by. the patient, and when pulled inwardly from the position shown in Figure 1, the delivery and bag valves are opened and the air passage closed, and when in use, the timer is set. In this case, therefore, a sufficient movement of the lever 93 as the result of gripping results in opening the delivery and bag valves and the initiation of a timing operation.

To set-the timer as the result of movement of the element 93 by gripping action of I the hand of the patient, the stemIiI is notched as at 96. Mounted on the plunger 8| is a cross-arm 91 in the tubular upper part of which is mounted a spring-controlled latch 98 adapted to engage the shoulder in a manner to couple with the rod 6| and pull it to the left from its position in Figure 2 against the action of the spring 65, to the release position, substantially shown in Figure 3.

Figure 2 shows the latch 98 in its initial position against the shoulder 96, and Figure 3 shows the parts as immediately after release of the latch. The latch assumes the position of Figure 2, whenever the patient allows grip lever 93 to The latch carries a cross pin I88 which engages a pair of cam arms I8I acting to raise the latch to the position shownin Figure 3, which figure shows the position of the parts just after the patient has gripped and moved the grip'element 93 inward- 1y to its limit position. In this figure, the timer is therefore operating.

It is evident that if the patient releases the grip, the plunger 8| will assume the position shown in Figure 2 and then if full gripping again takes place, before the stem has completed the timing movement, the latchwill again engage the shoulder and move the stem 6| again to the position shown in Figure 3. The plunger 8| is pulled to the position shown in Figure 3, also against the action of spring I83.

is tripped to release the valve 28 which then I moves under the action of the spring 43 resulting in closure of both valves 28 and 23. To accomplish this tripping there is non-rotatably mounted on the stem 6|, a trip arm 8 having a trip pin engageable with a cam surface 2 of the latch arm I85 to raise the latch against the action of the spring I81 to disengage the notch I86 from the pin 39. Tripping takes place when arm H8 arrives at the position shown in Figure 2. The transverse relation of she arm M8 to the latch arm I85 is shown in Figure 8, in which the spring acts to keep the lower end of H8 against the vertical faceof I85. Figure 8 is a somewhat diagrammatic section, meant principally to illustrate the manner of winding spring 65. It will be noted that, in this figure, the outer end of the spring is shown attached to the stem 6| but in practice it is attached at the point 61 to the piston 62, as shown in Figure 3.

Another feature of the invention is a safety' feature whereby tripping of the latch I85 to release valve 28 can be prevented. This is used to prevent opening of the air port and shutting off of gas, when it is desired to administer anesthesia, with the device still attached to the machine. It is used in conjunction with a lockout feature, which latter feature is described in my first case, Ser. No. 644,219, in which the element 86 is pulled outwardly so that its inner end abuts the outer end of the tubular element 82. This moves element 8| to and holds it in the position shown in Figure 3, so that the latch can no longer be engaged with the-shoulder 96 of the stem, and thus the timer cannot be operated. This locking of the valves in open position is possible because of the arrangement and relation of the elements as shown in Figure 1, that is the relation of the parts 86, 81, 88, 89, 98,9I,93, 85 and 8|. 1

For this purpose, see Figure 4, the cover 48 is provided with a tubular extension II5, and in threaded engagement with the bored? this extension is a stop H6 which can be adjusted by rotation, inwardly and outwardly from the full line to the dot-and-dash line positions shown. This pin, when in the dot-and-dash line position of Figure 4 (see also dot-and-dash line position of Figure 3) is adapted to be engaged by arm H8 to keep rod 6| from completing .its motion to the right. Its motion is arrested in such manner as to prevent the trip pin I II from engaging the camming surface 2 of the latch I85. Because of this, the latch cannot be tripped and therefore the valves 28,28 are held in open position. It will be noted that it is still possible for the patient to operate the plunger 8|, to bring it to the position shown in Figure 3 and release it, but the stem cannot take its full motion under the action of the spring 65.' All that is necessary then when it is desired to administer anesthesia is to move 6 to act as a stop for H8, and then pull 86 outwardly to. its locked position. It is noted that I I6 can be screwed to stop position at any time either before or after pulling 86 out to its locked position. It is desirable'to use 6 because even when the timer valve is closed to prevent timer action, there might be a leak which would-allow the stem to 'move a suflicient distance to the right, to cause tripping of the latch I85 by pin \I II carried by arm||8 ofthestem 6|. V I

Because the stem 6| can be rotated against the action of spring 65 in the manner previously mentioned, the stop 6 canv be screwed to the dot-and-dash line position shown in Figure 4,

slightly rotated to a position indicated by the dot-and-dash line A of Figure 4. However, as

the steni 6| is pulled to the left, the upper part of the arm II8'is disengaged from the stop 6 against the latch arm I05, as shown in Figure 8.

,controlled signaling means, operated by means of arm 54 and switch-55, see Figure 7: Either a is partly formed by theremovable bushing I38, 7

In this normalposition, the upper part of the arm .I I0 is so positioned as to engage the stop II6 during travel of the piston in timing direction, to prevent suflicient motion of the piston and arm to trip valve latch I05.

Continuing the description of the electrically buzzer of a lamp may be used, or both; and they may be operated separately or independently.

The lamp can be placed on the dentist's instru-v ment tray in front of the patient where it can be seen by both, to be lighted when the flow of analgesic substance is shut off.

Switch 55 controls, through manually operable switches I I1--I I8, circuits respectively for a light bulb H9, and for a buzzer I20. The source of electrical power is indicated at I2I.

switches 55 and I I1 only are closed the lamp II9 only is energized. When only switches 55 and H8 are closed, the buzzer I20 only is energized.

When switches 55, H1, and H8 are closed, both the light and the buzzer are energized.

Another feature of this invention relates to .means for removing carbon dioxide from the gases exhal ed by the patient; This device, shown inFigure 6,,is arranged as a detach- "able unit,, in the breathing line.

angularly related horizontal extension I25 of the tube I4, and includes a tubular member I26 having a friction fit, with the element I25. The passage provided by tube I26 communicates through screened opening, I21 with chamber I28, having a removable top. In this chamber is arranged, in any suitable form, fused caustic soda or other suitable carbon dioxide absorbing material. In this instance,

the soda has the form of pellets I29 and is aris ,in a continuation of passagel32. Passage,

I35 leads into passage I31 which communicates with the passage of tube I26. The passage I31 which has resting upon its upper end a. check valve I39 closing by gravity. The upward movement of the valve is limited by stop I40. Operating against the lower end of the sleeve I38 as a stop is a second check valve I4I seating' by gravity as at I42. Passage I31 leads into tube I43 to which is attached the flexible hose or breathing line I44 leading to the mask, not shown. a The valve I33 is for the purpose of controlling the fiow of exhaled gases so that they may or may not be forced to pass through the carbon dioxide absorbing substance I29.

In this case, as in my application previously of patient-control and while the main supply -unions generally indicated at I49. only one of the pipe connections is shown, it

This unit is attached in any suitable manner to a 'rightcontrol valve 23 is closed.- Either N 0 or oxygen or both may be by-passed and for this purpose,

suitable pipe connections are made with the machine as in the first mentioned case. Referring to Figure 3 a common by-pass chamber I48 receives gases or vapors mixed or not mixed,

through suitable plural pipe connections and Although ing slightly outwardly beyond the extension. I25.

The breathing tube I5I is suitably attached to a sleeve I52 which has a friction fit onthe end of theextension I25, as shown. To the end of the pipe I is attached a flexible piece of tubing I53 which extends a relatively short distance into the breathing tube I5I.

The carbon dioxide attachment, see Figure 6,

'has an inflexible tube I55 corresponding in functionto the tubes I50, I53, and this passes outwardly and has attached thereto a flexible connection I56 in turn attached to a nipple I51 which leads into the tube I43. This arrangement by-passes the valve I4I so that in an emergency, for example when oxygen is to be delivered, there will be no valve interference with the free supply 0t oxygen to the patient. The opposite end of thetube I55 is detachably connected with the tube I50 as at I58. The

carbon dioxide absorbing unit can be quickly applied or removed.

With the valve I33 positioned as shown in Figure, 6, and with delivery valve 23 open, the gases do not pass through the carbon dioxide absorbing c hamber, but re-breathing is possible Just the same. opened and valve I39 remains closed; 0n exhalation, valve I39 opens and valve I4I remains closed, the exhaled gas passing through valve On inhalation, valve MI is I39, passage I35, valv'e I33 and passage I34 through tubes I26 and I4, and acrossthe chamber formed by casing II to the bag, not shown. When the valve I33 is moved to its other position, indicated by the dotted position of the handle, the delivered gas to be inhaled takes the course previously described, but the exhaled gases pass through valve I39, passage I35, valve I 33, passage I32, chamber I28, through the caustic soda I29, and passage I21 to tube I4, thence to the bag.

Another feature of the invention which is an important one in this art relates to the provision of a volume control valve I60, see Figure 1, for controlling the volume of the mixed gas before delivery to the patient. The valve is preferably arranged between the gas mixing chamber of the machine and easing II for controlling the amount of flow of gases after mixing, all in a manner not to reduce the crosssectional area in,the actual breathing line, but so as to be able to vary the delivery valving to suit requirements for either analgesic or anesthetic dosage. This valve is herein located between the gas machine and the casing II, and this particular location is also claimed. Any

suitable type of valve can be used, and the ,ceaiva Timing operation Let it be assumed that, all the parts are positioned as shown in Figures 1 and 2 and that the patient desires to obtain a timed dose of analgesia. The patient strongly grips lever 93 and pulls it inwardly to its limit position, and plunger M is moved to the left, entraining stem 6! against the action of spring 65. Valve 20 is moved to the left to open the bag passage iii and close the air passage ll and valve 23 is and valves all move in the same direction. At the end of the timer-setting movement, pin mo of the latch engages the trip cam flti, and the latch is tripped to release the stem, see Figure 3. This tripping, of course, takes place while the patient is still strongly gripping and holding the lever 93 in its inward limit position. By-

thistripping, the timing operation is initiated and the stem starts its motion to the right under the action of springs. When trip bar Ht has nearly reached the position shown in Figure 2, pin iii engages tripping cam. face H2 of the valve latch I105, moving the latch upwardly to disengage the same from pin 39. The valves 2ll23 then move quickly from the position shown in Figure 3 to that shown in Figure 2 to she may bag, and

open the air passage and close the bag passage, and close the gas delivery passage. After this valve tripping has taken place, and after the patient releases the grip, the lower edge of latch arm Hi5 rides on pin 39, to latched position. Tripping takes place substantially at the end of the timing period.

By fully opening valve '58,.timing action by the pistonis stopped, although the stem is moved by the latch as before, whenever the valve controlling means is moved to the left by the patient. Timer action is also stopped by use of stop lit, as previously described.

The absorber can also be used in anesthesia by removing the casing ii and attaching the absorber structure directly to the gas delivering machine i. Ofcourse, it is usable for anesthesia when the valves are locked open by 86 and/or H6, during delivery of an anesthetic gas.

The tubular member it is for the purpose of attaching a receptacle which acts somewhat as a re-breathing receptacle for the air line. The function of this receptacle is fully described and claimed in my copending application above referred to.

The general procedure for using the device is as follows: Assume the patient to be a woman. She is seated in the chair, and the doctor places the grip in the patients hand. The nasal inhaler is then put on the patient's face, The doctor instructs the patient, and lets her operate the device before the gas is turned on, so that be familiar with her part. He then sets his regulators on the gasmachine, and causes the gas to flow. The timer is set, for example, to shut ofi the gas at the end of a minute. No gas flows to the patient, until the patient squeezes the grip. If, after the gas has taken eifect and the doctor has begun his operation, the patient feels herself losing consciousness, she releases the grip, to shut off the. gas,

open an air port toget air. In this invention, she can do this while the timer is operating, and may thereafter get additional gas at will, by reversing the procedure above mentioned. If the patient, through fear or pain, or inability of any kind, is unable to release the close the grip to stop gas and get air, the cut-out or timer operates automaticallyto do this.

It is to be noted that it is not true that all patients, when they feel themselves losing consciousness, release the grip. Some patients continue the gripping action and in this way receive. more gas instead of less gas as they should. It appears that some patients .are either no longer able to think clearly when they nearly approach the unconscious stage, or if they think clearly they are not, for some reason, able torelease their grip. A patient'oi .this kind is as like to do one thing as another, that is hold tightly or let go. The present device provides means whereby if the patient is not able to'let go, the gas will, in spite of this fact, be automatically cut off at the end of the timing period. On the other hand, the present device provides means whereby if the patient thinks he has enough gas before the end of the timing period, he can directly control the valves, independently of the timer, to cut off the gas supply and can thus shorten the gas delivery period.

Another feature, which is claimed herein, re-' lates to audible signaling by working those parts of the apparatus which are concerned with starting and stopping the supply of analgesic or anesthetic substance. Two signals are provided, one to indicate when gas flow has started and one to indicate when gas flow has stopped. The signal to show that gas flow is started and that air is'no longer available is given as a result of impact engagement of latch lilo with trip Elli, and/or of latch arm 9'1! with the vertical side wall of the casing H, or other equivalent part. The signal to show that gas flow is stopped and that air is available is given by impact of valve it with stop 20, see Figure 2. This latter signal is most dependably audible when it results from tripping of the valve latch M5 to cause automatic engagement of valve 20 against the stop 20. However, in case the patient releases the grip quickly, the spring brings the valve 26 against stop 28 with sumcient force to create the proper signal. These audible signals are valuable features and are sumcient for respective purposes independently of any of the signaling means heretofore may be used alone or signaling means previously described. I claim as my invention:

1. In combination with a machine for supplying inhalation fluids, a' breathing tube for the patient, an automatically closing valve for controlling delivery of the fluid from the machine to the tube, means manually operable by a patient for controlling hold it open and timing means adapted at the end of a timing period to annul the controlling action of said manual means and permit the valve to automatically and instantly close, while the valve-hold-open action of said manual means continues.

2. In combination with a machine for supplying inhalation fluids, a breathingtube for the patient, a valve for controlling delivery of the, fluid from the machine to the tube and a spring for closing the valve, means manually operable by a patient for positively controlling the valve to open it and hold it open and timing means having a movable element adapted, at'the end of a timed period, to annul the controlling action of said manual means and permit the spring to close the valve while valve-hold-open action in combination with the of said manual means continues,

described. Either or both 'trolling delivery of fluid from the 3. In combination with a machine for supplying inhalation fluids, a breathing line for the patient, an automatically closing valve for controlling delivery of the fluid through the line to the patient, patient-operable means for controlling the valve to open or close the same, including a part positively operable to open the valve, timing means adapted at the end of a timed period to annul the controlling action of said. manual means on said valve while said part of said manual-means is being positively operated, whereby, to permit automatic closure oi. said valve.

4. In combination with "a machine for supplying inhalation fluid, a breathing tube for the patient, an automatically closing valve for con-. trolling delivery. of fluid from the machine to the tube,means for timing the closure of the valve, means manually operable by a patient for controlling the timing means for setting the same to begin timing, and means automatically operable thereafter for'initiating timing action, means also controlled by said manually operable means for controlling the valve to open and close the same independently of the timing means, and means operable by the timing means for annulling the controlling action of the last mentioned means at the end of the timing period toobtain automatic valve closure.

5. In combination with a machine for supply ing inhalation fluid, a breathing tubeior the connecting with the valve to open and close the same independently of the iming means, and means operable by the timing means for disconnecting said last mentioned means at the end of the timing period to obtain valve closure.

6. In combination with a machine for supplying inhalation fluids, a breathing tube for the patient, an automatically closing valve for connachine to the tube, means ior'timing closure of the valve, means manually operable by a patient for connecting with the timing means and thereafter setting the timing means to begin timing, means automatically operable after such setting and during operation of the manual means for releasing said connecting means to obtain timing action, means controlled by said manually operable means for connecting with the valve; to open and close the same independently of the timing means, and means operable by the timing means for disconnecting said last mentioned means at the -end of the timing period to obtain independent valve closure.

7. In combination with a machine for supplying inhalation fluids, a breathing tube for the patient, an automatically closing valve for controlling delivery of fluid from the machine to the tube, means for timing the closure of the valve, means manually operable by an ungrasping action of the whole hand of a patient for connecting with the timing means and there after operable by a grasping action of the whole hand i'or. setting the timing means to begin timing, means automatically operable after such letting and during grasping action of the mansaid last'mentioned means at the end of the timing period to obtain valve closure.

8. In combination with a machine for supplying inhalation fluids, a breathing tube for the patient, a valve for controlling delivery of fluid from the machineto the tube, means for timing the closure of the valve, means manually operable by a patient for connecting with the timing means and thereafter setting the timing means to begin timing, and means automatically operable after such setting and during operation of the manual means for releasing said connecting means to obtain timing action, means controlled by said manually operable means for connecting with the valve to open and close'the' same independently of the timing means, means operable by the timing means for disconnecting said last mentioned means at the end of the timing period; and means operable as a result of valve closure to give a signal that such closure has taken place.

'9. In combination with a machine for supplying inhalation fluids either mixed or unmixed, a casing providing a chamber, a breathing and rebreathing tube for the patient, attached by one end to the casing and communicating with the chamber and having a mask at the opposite end, said casing having a fluid inlet passage into which fluids from the machine are delivered either mixed, or unmixed and further having a bag passage communicating with the chamber, each passage when open being in free communication across the chamber with the breathing tube and with each other, carbon dioxide extracting means including a carbon dioxide-absorbing substance, said means forming a part of the breathing and rebreathing tube, and including valve means part adjustable to permit or prevent passage of the exhaled fluidthrough the absorbing substance when on its way to the chamber, valve means controlling the fluid inlet and bag passages, patient-operable means controlling said last mentioned valve means, and means by which unmixed fluid from the machine can be delivered into said breathing tube at a point forwardly of the last mentioned valve means and forwardly of said carbon dioxide extracting means in direction of the patient.

10. In combination with a machine for supplying inhalation'fluids either mixed or unmixed. a casing providing achamber, a-breathing and rebreathing tube for the patient, attached to the casing and communicating with the chamber, said casing having a fluid inlet passage into which fluids from the machine are delivered either mixed or unmixed and further having a bag passage communicating with the chamber,

each passage when open being in tree communication across the chamber with the breathing tube and with each other, carbon dioxide extracting means including a carbon-dioxide-absorbing substance, said means forming apart or the breathing tube, and including valve means part adJustable to permit or prevent passage of the exhaled fluid through the absorbing subhen 'on its way to the chamber, auto controlling said last mentioned valve means to open the inlet and bag passage, and after cessation of such positive action to allow closure of said passages by the valve means, and means by which unmixed fluid from the machine can be delivered into said breathing tube .at a point forwardly of the last mentioned valve means and forwardly of said carbon dioxide extracting means in direction of the patient.

I 11. In combination with a machine for supplying inhalation fluids, a casing providing a cham-' her, a. breathing and rebreathing tube for the patient, attached by one end to the casing and communicating with the chamber and having a mask at the opposite end, said casing having a fluid inlet passage into which fluid from the machine is delivered, and further having a bag pa ssage communicating with the chamber, each passage when open being in free communication across the chamber with the breathing tube and with each other, carbon dioxide extracting means including a' carbon dioxide-absorbing substance, said means forming a part of the breathing and rebreathing tube, and including valve means part adjustable to permit or prevent pas-' sage of the exhaled fluid through the absorbing substance when on itsway to the chamber, valve means controlling the fluid inlet and bag passages, and meansmanually operable by a patient for controlling said last mentioned valvemeans.

12. In combination with a machine for supplying inhalation fluid, acasing providing a chamber, a breathing tube for the patient attached to the casing and communicating with the chamber, said casing having a fluid inlet passage through which fluids from the machine are delivered (to the chamber, and further having a bag passage, each passage when open being in free communication across the chamber with a breathing tube and with each other, a first automatically closing valve controlling the intake passage, a second automatically closing valve controlling the bag passage, means by which the second valve controls the first to open or close it when the bag passage is opened or closed, and means manually operable by a patient for controlling the bag valve.

13. In combination with a machine for supplying inhalation fluid, a casing providing a chamber, a breathing tube for the patient attached to the casing and communicating with the chamber, said casing. having a fluid inlet; passage through which fluids from the machine are delivered to the chamber, and further hav-'- ing a bagpassage, each passage when open being in free communication across the chamber with a breathing tube and with each other, a first automatically closing valve controlling the intake passage, a second automatically closing valve controlling the bag passage, means by which the second valve controls the first to open or close it when. the bag passage is opened or closed, means manually operable by a patient by release and positive actions respectively for connecting with the bag valve and then opening the same, means for timing a delayed closure of the valves, means operable by release action of said manual means for connecting with the timing means, and thereafter on positive action setting said means to begin timing, means automatically operable after setting for releasing said connecting means to obtain timing action,

-from'the machine are delivered to the chamber,

and further having a bag passage and an air intake passage both communicating with the chamber, each passage when open being in free communication across the chamber with a breathing tube and the bag passage when open being in free communication with both the breathing tube and the intake passage, a first automatically closing valve controlling the intake passage, a second valve adapted for alternately controlling the bag and air passages, and automatically movable to close the bag passage, means by which the second valve controls the first to open or close it when the bag passage is opened or closed, means manually operable by a patient-by release and positive actions re-- 'spectively for connecting with the bag valve and then openingthe same, means for timing closure of the valves, means operable by release action of said manual means for connecting with the timing means and thereafter on positive actions setting said means to begin timing, means automatically operable after setting for releasing said connecting means to obtain timing action, and means operable by the timing means for disconnecting said patient-operable bag valve control means at the end of the timing period.

15. In combination with a machine for supplying inhalation fluids, means by which flow of fluid to the organsof respiration is controlled including a self-closing valve, means manually operable by the patient foropening and closing the valve including a latch in releasable relation with the valve, timing means, means by which the manually operable means sets the timer as it opens the valve, and automatically initiates timing actions at the end of the valveopening operation, said timing means being adapted at the end of the timing period to trip the latch to allow valve closure while said manually operable means is in valve-open position.

16. In combination with a means for supplying inhalation fluids, means by which flow of fluid to the organs of respiration is controlled including a valve, timing means, means manually operable by the patient for controlling the valve, to open and close it, including means for setting and automatically releasing the timing means at the end of the valve-opening operation, and means acted on by said timing means atthe end of the timing period to cause the valve to close independently of any control action of the manually operable means.

1'7. In combination with a machine for. supplying inhalation fluid, a casing providing a chamber, a breathing line for the patient attached to the casing and communicating with the chamber, said casing having a fluid inlet passage into which fluids from the machine are delivered and further having a bag passage communicating with the chamber, each passage when open being in free communication across the chamber with the breathing tube and with each other, a carbon dioxide extracting means formingmart of the breathing line, automatically closing valve means controlling fluid inlet and bag passages and means manually operable by the patient for controlling the same, pnd'means 75 by which unmixed fluid from the machine can -'be delivered into the breathing line without ently of said timing means while said timing means is operative.

19. In combination with an apparatus for administering inhalation fluids, means by which flow of fluid to the organs of respiration is controlled including a valve, means for timing oldsure of the valve-including a stem, manual means operable by the patient for controlling the valve independently of said timing means while said timing means is operative, including parts operatively associated with said stem for initiating timer action when the valve is opened.

20. In combination with a machine for administering inhalation fluids, means by which the flow of fluid to the organs of respiration is controlled including a breathing line, a patientoperable valve controlling entry of inhalation fluid into said line, a carbon dioxide absorbing means operatively associated with said line, and means by which fluid from the machine can be delivered into said breathing line to'reach the patient without passing .through said patientcontrolled valve nor through said carbon dioxide absorbing means. 4

21. In combination with 'a machine for administering inhalation fluids, means by which the flow of fluid to the organs of respiration is controlled including a tube through which the patient breathes and rebreathes, a valve controlling entry of inhalation fluid into said tube, carbon-dioxide absorbing means forming part of said tube, and valve means part adjustable to permit or, prevent passage of exhaled fluid through said absorber.

22. In combination with a machine for administering inhalation. fluids, means by which the flow of fluidto the organs of respiration is controlled including a tube through which they patient breathes and rebreathes, a valve controlling entry of inhalation fluid into said tube,

carbon dioxide absorbing means forming part of said tube, valve means part adjustable to permit or prevent passage of exhaled fluid through said absorbing means, and means by which fluid from the machine can be delivered into'said' breathing tube to reach'the patient without passing through said valve nor through said carbon dioxide absorbing means.

23. In combination with a machine for supplying inhalation fluids, first means for controlling flow of fluid t the organs of respiration,

and operable for automatically stopping the flow,

second means. controlling the first means and operable by the grasping action of the hand of a patient for initiating flow and thereafter permitting independent, action of the first means to stop the flow while the grasping action of the control continues but requiring release preparatory to another flow-initiating operation,f and signal means controlled by the first means and operable to startle the patient when said first means has stopped the' flow, whereby the patients obtunded sensory faculties are stimulated to' prompt him to release his'grip on the second control means to condition said means for another operation, and whereby the proper respouse by the'patient to the signal is indicative to another person of the proper sensory state oi.

the patient.

stop the flow while the grasping action of the control continues but requiring release preparatory to another flow-initiating operation, and electrically operable signal means controlled byv the first means and operable to startle the pa- I tient when said first means has stopped the flow, whereby the patients obtunded sensory faculties are stimulated to prompt-him to release his grip on the secondcontrol means to condition said means for another operation, and wherebythe proper response by the "patient to the signal is indicative to another person of the proper sensory state of the patient. I

"' WALTER R. HENION. 

